Provider Demographics
NPI:1073808432
Name:DARRAH, MEGAN B (MOT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:B
Last Name:DARRAH
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:B
Other - Last Name:TENNANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:6 EDWIN STREET
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501
Mailing Address - Country:US
Mailing Address - Phone:304-292-0173
Mailing Address - Fax:304-292-0174
Practice Address - Street 1:6 EDWIN STREET
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501
Practice Address - Country:US
Practice Address - Phone:304-292-0173
Practice Address - Fax:304-292-0174
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVLPT 340225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist